Module

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Clinical Autonomics

This module addresses key clinical connections (applications) of autonomic physiology and pharmacology and has been used in an introductory veterinary autonomic physiology unit.

Learning ObjectivesGeneral Principles
1. Understand the dominant autonomic tone in the following tissues: g.i., cardiac, blood vv., bronchioles, bladder, iris m. of eye.
2. Be aware of cellular signal transduction pathways that may serve as a way of integrating the simultaneous agonist effect of a muscarinic and adrenergic agonist.
3. Provide the rationale for the use of various classes of autonomic drugs for the treatment of a) acute heart failure, shock and hypotension, b) acute anaphylaxis, c) acute renal failure, d) vasoconstriction and decongestion, e) asthma and chronic obstructive (bronchoconstrictive) pulmonary disease, and f) nonnarcotic analgesia/sedation, and g) urinary tract dysfunction.Autonomic cholinergic (muscarinic) effects and drug classes
1. Provide the major tissue locations of muscarinic receptors.
2. Explain the difference between a direct and indirect-acting cholinergic agonist.
3. Describe the major effects of muscarinic agonists on heartrate, blood pressure, g.i. and tracheal/bronchial smooth muscle, secretions and pupillary diameter.
4. List and rationalize the most important clinical indications of muscarinic agonists.
5. Explain the side effects of a cholinesterase inhibitor as represented in the “SLUD” syndrome.
6. List and rationalize the most important clinical indications of muscarinic antagonists.Adrenergic effects and drug classes
1. List tissues containing significant amounts of α1, α2, β1, β2, β3, D1 and D2 receptors.
2. Describe the major effects of agonism against the receptors listed in objective 1.
3. Explain the difference between a direct and indirect-acting cholinergic agonist.
4. List and rationalize the most important clinical indications of α1, α2, β1, β2, and D1 antagonists